209 Big Oak Lane Lot 1Davie Countv. NC
Tax Parcel Renort
Wednesday. November 2. 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
WARNING: THIS 1S NOT A SURVEY
Parcel Information
F60000005306 Township: Farmington
5851804932 Municipality:
82532123 Census Tract: 37059-803
PUKANECZ ELIZABETH R Voting Precinct: SMITH GROVE
209 BIG OAK LANE Planning Jurisdiction: Davie County
MOCKSVILLE Zoning Class: DAVIE COUNTY R -A
Land Value:
Total Assessed Value:
NC
Zoning Overlay: DAVIE COUNTY QD
27028-0000
Voluntary Ag. District:
No
5.00 AC OFF HWY 158 LOT 1 BIG OAK
Fire Response District:
SMITH GROVE
4.93
Elementary School Zone:
PINEBROOK
1/2006
Middle School Zone:
NORTH DAVIE
2006EO040
Soil Types: MrC2,MrB2,EnB
0007
Flood Zone:
051
Watershed Overlay:
DAVIE COUNTY
137850.00
Outbuilding & Extra
10580.00
Freatures Value:
48620.00
Total Market Value:
197050.00
197050.00
All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or Illness for a particular use. AN users of Davie County s GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
�T
l� C or arising out of the use or Inability to use the GIS data provided by this website
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AUTET,oRIZA ; ON No: '] j Q DAVIE �OUNTY HEALTH DEPARTMENT
Ap Environmental Health Section . PROPERTY INFORMATION
Permittee's / / P.O. Box 848
Name: Mocksville, NC 27028 Subdivision Name: A2
Phone # 336-751-8760
Directions to property: %r Section:Lot:'
AUTHORIZATION FOR ,,t
WASTEWATER Tax Office PI
SYSTEM CONSTRUCTION -
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Road Name r . p, of 0
**NOTE** This .Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections `
Office when applying for Building Permits.
(In compliance with Article I I of G.S.: Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
*NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH S dALIST DATE ISSUED
2 ♦ ��y
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17-30 " DAVIE OUNTY HEALTH DEPARTMENT G`
P IMPRO,EMENT AND OPERATION PERMITS PROPERTY INF RMATION
Permittee's ,'
F, Name: ' i Subdivision Name:
Directions to property: -" ✓' + t� Section:_ Lot:,
r'�y IMPROVEMENT
PERMIT' A
'� Tax Office PI
�,. . ;, .�' • Road Name; zip:
**NOTE**This,Improvement Permit DOES NOT authorize the'construction or installation of a septic tank system or any wastewater system.An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
(Inlcompliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***,THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR:WASTEWATER
' SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
ENVIRONMENTAL HEALTH SPECIALIST DATE,ISSUED' INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE�_ #BEDROOMS _#BATHS_sz2#OCCUPANTS _GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT -�j#SEATS /INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY /� DESIGN WASTEWATER FLOW(GPD) NEW SITE li' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE b GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
i,
P
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30-9:30"A.M.OR 1:00 1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS (336)751-8760.
OPERATION PERMIT I -
Qp0 SYSTEM INSTALLED BY:
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AUTHORIZATION N0.�.�1 OPERATION PE $ DATE:
**THE ISSUANCE OF THIS OPERATION PERMrr SHALL I ATE THAT THE SYS M SCRIBED ABOVE HAS BEEN INSTALLED IN CO LIANCE
WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION:1 "S WAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO WAY BE TAKEN AS A'
GUARANTEE THAT THE SYSTEM WILL FUNCTION SA FA DRILY FOR ANY GIVEN PERIOD OFTIME.
DCHD 051%(Revised)
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kA 1.7-30 DAVIE COUNTY HEALTH DEPARTMENT
*"
IMPROVEMENT, AND OPERATION PERMITS PROPERTY INF RMATION
Permittees
Name:" �% 1) Subdivision Name:
F
Directions to pro erty: Section:_ Lot:
IMPROVEMENT +��`,=��'
PERMIT Tax Office PI
Road Name: Zip:
**NO * This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
constructionhnstallation of a system or the issuance of a building permit.
ompliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
•r INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE _� # BEDROOMS # BATHS 5! # OCCUPANTS 7 GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS IINDUSTRIAL WASTE: Yes or No
LOT SIZE % IC wTYPE WATER SUPPLY`'' f / ` DESIGN WASTEWATER FLOW (GPD) NEW SITE L/ REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE G71 GAL. PUMP TANK - GAL. TRENCH WIDTH ROCK DEPTHLINEAR FT. •_� l f/
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
4tih
OPERATION PERMIT 1i O �"r��t{ �/-'
UD SYSTEM INSTALLED BY: �b Q/VA�TZ aC
lq�
*'y'
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X
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AUTHORIZATION NO. OPERATION PE �il DATE: >
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL HIATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN CO PLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1 "S WAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SA FA ORILY FOR ANYGIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
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APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 848.
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED -UNE
ALL THE REQUIRED INFORMATION IS PROVIDED.
Name to be Billed R* -le /y e S J /Z Contact Person _
Mailing Address 3:5 7.0 A/W Y /S7- b
City/State/Zip �fo�Ks l/ / c L AJ6, Z 7 0 2 a
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For:
4. System to Serve:
5. If Residence:
❑ Dishwasher
City/State/Zip
al_) I _6y
S4 A, C
Home Phone 9'50 z / .3 T
Business Phone
Site Evaluation N"' Improvement Permit & ATC
0' House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
# People 1-'
❑ Both
# Bedrooms 3 # Bathrooms Z-
0
❑ Garbage Disposal GY Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other: Specify type
# Commodes
If Foodservice:
7. Type of water supply:
# Showers
# Seats
❑ County/City
# Urinals
# People # Sinks
# Water Coolers
Estimated Water Usage (gallons per day)
3"Well
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
❑ Community
❑ Yes a—No
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
4oODAse s- SUBMITTED WITH THIS APPLICATION.
Property Dimensions: 7x'3.014 y3 `( flY S d.) , Y P X 4a 3 Y 1 WRITE DIRECTIONS (from
_ ocksville) TO PROPERTY:
Tax Office PIN: # P
Property Address: Road Name 00F:1007
r 1 L v 97'46A
City/Zip /
If in Subdivision provide information, as follows: 1
ol
Name: Q� c ��K �Sfrtrf cJ 1
1 A
1
Section: Lot #: �i 1
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter
are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is
falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to
the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County
and owned by /Ioc-, r C /1)/e'ece to conduct all testing procedures
as necessary to determine the site suitability.
DATE Z%- /- �A- SIGNATURE
Revised DCHD (06-96)
AVol' 4?511�3
4W. a 9!4,
j• J ` APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI
Davie County Health Department n LS V l5
Environmental Health Section �1
T P. O. Box 848 WR 2 4
Mocksville, NC 27028
(704) 634-8760 - _---
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSE
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed „wg < < ! I e Q c e �gn. M.-�� T Contact Person �T—tS M t
Mailing Address Home Phone
c.xw
City/State/Zip � - IJ L 2- O ,�a Business Phone
2. - Name on Permit/ATC if Different than Above
Mailing Address
3. Application For:
4. System to Serve:
5. If Residence:
❑ Dishwasher
0"'Site Evaluation
O" -House ❑ Mobile Home
# People
City/State/Zip
❑ Improvement Permit & ATC
❑ Business ❑ Industry
# Bedrooms
❑ Other
# Bathrooms
❑ Both
❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other: Specify type
# Commodes
If Foodservice:
7. 'Type of water supply:
# Showers _
# Seats
❑ County/City
# People # Sinks
# Urinals
Estimated Water Usage (gallons per day)
❑ Well
# Water Coolers
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
❑ Community
❑ Yes ❑ No
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions:
f /Y a/? �
I
WRITE DIRECTIONS (from
PIN: #
r
Mocksville) TO PROPERTY:
Tax Office
Property Address: Road Name
1\�(
e.
City/Zip
I
If in Subdivision provide information, as follows:
1
� -e�--P
Name: :7 5�
1 S f%��s
;
Section:
Lot #:
1
1
1
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter
are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is
falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to
the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County
and owned by o 'S S �',-e,Qce— to conduct all testing procedures
as necessary to determine the site suitability.
DATE 3 oZ3' cl SIGNATURE
Revised DCHD (06-96)
T DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION L_ LOTJ
Soil/Site Evaluation
w
APPLICANT'S NAME �� rS� ✓ i FrL� e DATE EVALUATED
PROPOSED FACILITY PROPERTY SIZE 1.4 47,
SUBDIVISION
ROAD NAME /5�Z
Water Supply: On -Site Well Community/ Public
Evaluation By: Auger Boring �� Pit t/ Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH `' y
Texture groupG. L'
Consistence
Structureak
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: PJOyee l�_, Z r' Cl'�LUATION BY: A04�
LONG-TERM ACCEPTANCE RATE: _ D' r le OTHER(S) PRESE
/ VY 12f
REMARKS: ''/�.� ,7416-' e-& 0707✓
LEGEND
Landscape Position
R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope
CC - Concave slope CV - Convex slope T - Terrace FP - Flood plain H - Head slope
Texture
S - Sand LS - Loamy sand SL - Sandy loam L - Loam SI - Silt
SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay C - Clay
CONSISTENCE
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
Wet
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
Structure
SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineralogy
1:1, 2:1, Mixed
Notes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2
DCHD (O1-90)